Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

12th World AIDS Conference

Abstracts 43345-43350 915

ity especially for women and young people to be able to sustain independent
livelihood.
Conclusion: The available positive-living services bear considerable influence
on PHAs awareness and perceptions related to a range of positive living issues,
but seem to be ineffective in addressing the psychosocial and economic dynamics
responsible for their continued involvement in risky sexual, reproductive, nutritional and care practices. New positive living models should utilize intervention
components that would ensure expansion and provision of HIV/AIDS testing,
information, preventive devices, care and counseling services alongside artisan
skills development and economic support to grass root communities.
43345 Networks against AIDS: Organising bisexuals of Calcutta
Debangshu Mukherjee, Sudipta Mitra1, Protik Banerjee1. Project Volunteer,
'PRAAJAK, 468A Block-K New Alipore, Calcutta, India
Issue: In India, bisexuality, as a phenomenon, is denied as of very significance.
Invisibility of bisexuals has thus made them vulnerable to AIDS.
Project: Recent studies in male sexual behaviour in Calcutta has revealed
that bisexual males practise risky sexual behaviours, do not use condoms with
partners, are more likely to have anonymous sexual encounters in cruising areas
and are less likely to socialise with other bisexuals. Outreaching bisexuals with
safer sex messages becomes very difficult. Efforts to organise bisexuals into a
supportive network was initiated to overcome these problems.
Results: A few bisexual men who came together as a result of participating in
AIDS campaigns decided to get together. They have been able to motivate other
bisexuals to hold regular meetings to discuss their problems. This has helped
in spreading awareness of safersex among bisexuals and the risk their female
partners face. Educational material specific to needs of bisexuals have also been
developed.
Lessons Learned: Organising and visibilising sexual minorities is imperative
for the success of AIDS prevention campaigns.
S43346 Needs assessment design among truckers on a national
highway
Narayanan Hariharan, T.J. Devadas, T. Abraham Dr., R.S. Mani. Accept 9
Nadhamuni Street Shenoy, Nagar Madras 600030, India
Issue: The high prevalence of STDs among Truckers and their affiliates is well
established in India. However, to suit the needs of the truckers, an area specific
needs assessment design was undertaken amongst 180 Truckers & their affifiliates on NH-5 between Annakapalle and Tuni in the State of Andhra Pradesh,
India.
Project: A four month study using quantitative and qualitative techniques led
by a researcher and conducted by a team of two health educators and one
journalist was conducted. Emphasis was given on qualitative information, using
focus group discussions.
Results: The prevalence of STDs is well accepted by the trucking and the sex
work industry. The efficacy of condoms and the need to treat STDs are also well
recognised. However, various stumbling blocks, especially attitudinal in nature,
hamper this knowledge from being put to practice.
Lessons Learned: Existing STD services, condom programming and behaviour change communication needs to be upgraded, fine tuned and packaged
for the specific needs of the truckers, their affiliates and sex partners.
43347 The street walkers of Dhaka City: STD/HIV risk among
street based sex workers of Dhaka City
Maurice Bloem, Ziya Uddin, S. Sarkar, Y. Ahmed, N. Islam, A. Quader,
E. Hoque. Shakti-Project, Care - Bangladesh, H#60, Road - 7A, Dhanmondi,
Dhaka, Bangladesh
Objective: To collect data regarding socio-economic situation, high risk generating behavior, pattern of STD/HIV and health seeking behavior of the street
based sex workers and to design and develop an HIV/AIDS and STD intervention
program targeting them in Dhaka City.
Methods: Ethnographic field observation was used to identify the locations,
sex workers were recruited as guides. Capture-recapture method was used to estimate the size. Depending on condom use sample size was determined and 230
sex workers were recruited from the street for behavioral interview, clinical examination and laboratory test. Endocervical swabs for gonorrhea and blood samples
for VDRL, Chlamydia and anonymous HIV testing were collected. Samples were
simultaneously tested in Dhaka, Bangladesh and UK.
Results: They were approximately 5000 street based sex workers, who operates from 60 locations. The mean age was 22 yrs and 25% of them less then
18 yrs, the legal consent age sex. Thirty percent reside in side walks, parks or
railway platform. Thirty-four percent women reported having more than one sex
partner in the last 24 hours. Fifty six percent had sex during menstruation. One
sixth reported ever practicing anal sex. Sixty-eight percent had sex more than

3 times per day. Only two percent reported consistent condom use, 34 percent
used in less than 50 percent sexual act. Forty three percent and 57 percent had
knowledge about sexual transmission of STDs and AIDS respectably. Eighty percent mentioned to have vaginal discharge and 40 percent had burning sensation
during urination. In clinical examination 69 percent had vaginal discharge, 62
percent had cervical discharge and 55 percent had both vaginal and cervical discharge. On laboratory examination TPHA and VDRL were found positive for 52%

and 29% respectively. PCR positive were found 53% and 49% for Gonorrhoea
and Chlamydia respectively. There was no positive case for HIV.
Conclusion: The situation of high prevalence of STD and absence of HIV
among the street sex workers underscore for immediate HIV/AIDS and STD
control intervention. Nature and size of the target population calls for partnership between different organizations. Appropriate out reach service should be
established for the street sex workers. Sex workers should be recruited and
trained as peer educator to disseminate messages and risk reduction materials
like condom.
43348 STD/AIDS prevention in primary health care setting in
redlight districts
Uchal Kumar Bhadra1l2, M.K. Pradhan3. 1B-23 Jayasheree Park, Calcutta
700034; 2Medical College, Calcutta 3 The Society for Community Development,
Calcutta, India
Issue: Redlight districts need targeted intervention but STD clinics may be less
appropriate than holistic Primary Health Care approach.
Project: A free STD clinic was established by a group comprising of an NGO,
the government and the WHO in a redlight district with an STD specialist, a nurse,
paramedics and peer group workers trained in STD/AIDS prevention. Following
its success (condom use rose by 65.1%) the NGO decided to test whether a
holistic primary health care (PHC) approach with a strong STD/AIDS component
could be more effective. It sponsored, assisted by a dutch funding organisation,
six separate red light district outposts with public health medicine specialists in
charge and trained paramedics and peer group workers. The program was PHC
with consultation and treatment for a token registration fee, and regular meetings
with sex workers, pimps, local doctors, and clients in addition to door-to-door
visits, addressing community health needs comprehensively.
Results: The program did not seggregate STD sufferers, preserving confidentiality. Condom demand rose by 114.9% and condom use by 73.2%. Holistic
approach ensured good community participation.
Lesson Learned: As a preventive strategy, holistic PHC with an underlined
STD/AIDS component can elicit a better community participation. This is perhaps
especially appropriate for developing countries in early epidemic, as they may
already have good PHC infrastructure owing to actions already taken on account
of Health For All By 2000 A.D.
43349 Sexual workers capability to participate in the design of
boarding of HIV/AIDS prevention in northeast of Brazil
Silvia Bastos1, L.A. Moreno Montalvo2, R.S. Sampaio3. 1AV Almirante Barroso
600 60060-440 Fortaleza Ceara Health Secretariat of State of Ceara Fortaleza
CE; 3Aproce Fortaleza CE, Brazil; 2Coin Santo Domingo, Rep. Dominican
Issues: The preventive methological boarding and behaviour utilized in education
actions have been put in question by sexual workers from Fortaleza City, who
front difficulties and resistences to agree with preservatives all of their clients and
their firm partens.
Project: The Prevention Project HIV/AIDS among sexual workers (SW) had a
partnership between Ceara Prostitutes Association and Ceara/Brazil Health State
Secretariat. From June 1995 to December 1997 their activities were begun. They
have attended 1.608 women in six areas in Fortaleza, a city that has more than
2.000.000 habitants with intense turist point. According with the valuation realized
beside the group, it was noticed the necessity of reorganizing the intervention
boarding design strategy. A group of technicists from Prevention and Evaluation
area beside to leadership of the group, realized open country visits and well done,
experiences change, fallowed by a cycle of five workshop to capacitate, stimulate
and improve sexual workers decisions, with the intention of instructing them and
fortify them to participate in the intervention design again.
Results: From the workshop resulted: 30 leaders capable as multiplying: a
design guide and education material validation beginning from indirect behaviour
indicators; a clinic advise agreement of the SW with public health service and a
minimum curriculum of capacitating for WS, that consists of human developement
aspects in the sexuality, oneself esteem, gender, health and leadrship.
Learned Lessons: The education interventions design must be participative
and it must attend the aspirations, expecatations and viability of the specif
population to be destined to.
|43350 AIDS prevention practices through literacy and
empowerment
Jones Cedrick Labana. P.O. Box 42, Mangochi, Malawi Central Africa
Issues: The objective of this project is to reduce HIV and STDs transmission
among Women at risk. These are Women (who are mostly single) who engage in
commercial sex work to earn a living. The women are illiterate, unemployed and
some are mothers.
Project: Training of at-risk women in literacy and life skills to enable them find

alternative source of income to sex. The project is divided into three phases to
make one cycle. Each phase takes three months covering specific lessons.
Phase I: Foundation: This phase focuses at widening their scope using simple
drawings e.g picture codes, graphs. The participants are made to examine their
own surroundings.
Phase 2: Health: In this phase focus is primarily on health topics e.g. health
and hygiene, nutrition, STDs, body mapping.